Cancers of the lip are the leading cause of labial defects, and treatment is essentially surgical. The success of a repair is assessed by two essential criteria: The functional character of the lip (restoration of con...Cancers of the lip are the leading cause of labial defects, and treatment is essentially surgical. The success of a repair is assessed by two essential criteria: The functional character of the lip (restoration of continence allowing feeding) and the aesthetic quality of the repair. However, for many patients from countries whose medical infrastructure does not allow them to undertake complex reconstructions locally, medical transfers represent their only chance of treatment. The aim of this article is to share with you an extreme clinical case of labial reconstruction, the management of which was a real challenge, using two major flaps: the free ante-brachial flap and the DUFOURMENTEL-type bi-pediculated scalp flap.展开更多
Introduction: Squamous cell carcinomas of the lip essentially pose a therapeutic management problem. In the West, their treatment is done under general anesthesia and follows the classic rules of oncology. In our cont...Introduction: Squamous cell carcinomas of the lip essentially pose a therapeutic management problem. In the West, their treatment is done under general anesthesia and follows the classic rules of oncology. In our context of exercise, we sometimes have a different attitude dictated by various constraints. Observation: 55-year-old patient with no notable history, seen in consultation for a very large ulcerative-budding lesion on the right 2/3 of the lower lip with mucocutaneous involvement without lymph node findings found on examination. Faced with this suspicious lesion and the patient’s financial difficulties, we decided to operate under local anesthesia to remove this tumor. The oncological excision was followed by immediate plasty using a Camille-Bernard flap with a good immediate aesthetic and functional result and postoperative day 7. The patient was unable to take his surgical specimen to anatomy-pathology and was lost to follow-up due to lack of financial resources. On anatomo-pathological analysis of the surgical specimen, the margins were healthy with confirmation of squamous cell carcinoma (anapathological reading made for scientific interest). Discussion: The particular mentality of certain patients and their difficult financial conditions push us to have an unconventional therapeutic attitude in oncology, but which nevertheless makes it possible to resolve certain problems that we often face. Local anesthesia is possible and realistic in cases like ours and the results can be acceptable and life-saving.展开更多
BACKGROUND Salivary gland tumors are relatively rare.Most minor salivary gland tumors are malignant with benign tumors accounting for 18%of the tumors.Pleomorphic adenoma(PA)is the most common salivary gland tumor.Lip...BACKGROUND Salivary gland tumors are relatively rare.Most minor salivary gland tumors are malignant with benign tumors accounting for 18%of the tumors.Pleomorphic adenoma(PA)is the most common salivary gland tumor.Lip PA is uncommon with 9.8%occurring in the upper lip.We are adding on the knowledge of the rare upper lip PA(benign mixed tumor).CASE SUMMARY We report an upper lip PA(benign mixed tumor)in a 28-year-old man.His complaint was a painless swelling on the upper lip.A painless,non-tender,well-circumscribed,slightly mobile,sessile,nodular,and rubbery(in consistency)tumor measuring 5.0 cm x 2.0 cm was noted on the left side of his upper lip.The overlying skin was not fixed and of normal color.There was no ulceration,and palpation did not elicit pain or bleeding.There was no history of trauma.Blunt dissection was used to completely excise the nodular,whitish,and encapsulated tumor.Microscopy showed a well-circumscribed and partly encapsulated biphasic lesion,with large lobules of myxo-chondroid stroma and intervening cellular nodules of basaloid cells,well-formed tubules containing eosinic secretion,and nests of myoepithelial cells.A diagnosis of PA(benign mixed tumor)was confirmed.CONCLUSION Blunt dissection is indicated to preserve the cosmesis and function of the upper lip.展开更多
Congenital unilateral lower lip palsy(CULLP),or congenital hypoplasia of the depressor anguli oris muscle,also known as asymmetric crying facies,is a rare condition that results in asymmetry of the lower lip during sm...Congenital unilateral lower lip palsy(CULLP),or congenital hypoplasia of the depressor anguli oris muscle,also known as asymmetric crying facies,is a rare condition that results in asymmetry of the lower lip during smiling,laughing,and crying.Although the etiology is unknown,weakness of the depressor labii inferioris(DLI)muscle is implicated as a contributing factor.Currently,no well-established treatment options are available.This case report describes an 18-year-old male patient diagnosed with CULLP.Physical examination revealed a symmetric face at rest,but asymmetry when smiling and opening the mouth.Following the administration of lidocaine into the affected DLI muscle,the patient’s smile and lower lip symmetry were immediately restored without any adverse effects.Subsequently,administration of botulinum toxin for neuromodulation of the DLI muscle led to a significant improvement in symmetry and oral function within 2 weeks,which was sustained at 1 month and 3 months post-treatment.No adverse effects were reported,and both patients and families expressed high satisfaction with the outcomes.This case highlights the potential use of neuromodulation as a minimally invasive and effective treatment for CULLP.展开更多
To study the efficacy of lip moisturizing cosmetics and explore the methods for evaluating their efficacy.The claimed efficacy and number of claimed efficacy of 44 lip moisturizing cosmetics were investigated,and a co...To study the efficacy of lip moisturizing cosmetics and explore the methods for evaluating their efficacy.The claimed efficacy and number of claimed efficacy of 44 lip moisturizing cosmetics were investigated,and a combination of in vitro and human testing was used to evaluate the efficacy of the lip moisturizing cosmetics.The efficacy claims of lip cosmetics mainly included 4 categories of moisturizing,repairing,soothing and anti-wrinkle,with 79.55%of the products claiming 3~4 categories of efficacy.In the in vitro test,the cell morphology of the skin damage model improved and the secretion of pro-inflammatory factors decreased significantly.In the human trial,the water content,skin softness and brightness L value of the cuticle of the lips increased significantly in 31 subjects,and the transepidermal water loss,redness a value,and the area and volume of lip wrinkles decreased significantly;the dryness of the lip skin and the uniformity of the skin texture improved significantly.The dryness of lip skin and the uniformity of skin texture were significantly improved.The results show that the moisture content of the stratum corneum can be used to evaluate the moisturizing efficacy of lip products.The transepidermal water loss,skin color,skin softness and expert assessment can be used to evaluate the repairing efficacy.The observation of cell morphology of skin damage models and the detection of pro-inflammatory factor content can be used to evaluate the soothing efficacy.The area and volume of lip wrinkles can be used to evaluate the anti-wrinkle efficacy of products.展开更多
Green-lipped mussel, Perna viridis is a warm water mussel species that is distributed widely in the Indo-Pacific regions. It is a commercially important species and has demonstrated a great culture potential in tropic...Green-lipped mussel, Perna viridis is a warm water mussel species that is distributed widely in the Indo-Pacific regions. It is a commercially important species and has demonstrated a great culture potential in tropical countries. The feeding behavior of P. viridis is influenced by both seston concentration and its nutritional values. It is shown the mussels exhibit higher ingestion rate when the organic content of the seston is higher. Interestingly, several studies have reported that P. viridis can demonstrate selective feeding behavior towards phytoplankton. Short term studies have shown that the P. viridis exhibits preferentially ingestion of dinoflagellates, while long term studies show that the P. viridis has a higher growth rate during diatom blooms. Nevertheless, spawning of P. viridis is induced by high primary productivity at relatively high sea water temperature. In the temperate countries, spawning is seasonal but normally occurs in summer. In the tropical countries, however, the P. viridis has been shown to spawn all year-round with two peaks which coincide with monsoon seasons. The site selection is critically important when considering the green mussel culture. Feasibility study for P. viridis farming is normally carried out first in order to evaluate the environmental conditions of the site. This paper attempts to review the current knowledge of biology, selective feeding behaviour, growth, reproductive and the aquaculture site selection methods for green-lipped mussel.展开更多
Introduction: Cleft lip, palate and alveolar (CLPA) are congenital malformations of the face due to a defect in the fusion of embryonic buds during the first weeks of embryogenesis. These malformations affect the uppe...Introduction: Cleft lip, palate and alveolar (CLPA) are congenital malformations of the face due to a defect in the fusion of embryonic buds during the first weeks of embryogenesis. These malformations affect the upper lip, the alveolar bone and the palate. The incidence in Africa ranges from 1/2000 to 1/500 births. Their multidisciplinary management is long and costly. Thus, the help provided by humanitarian organisations during free care campaigns is welcome. Materials and Methods: This is a retrospective descriptive study conducted from August 2014 to July 2016 in the Maxillofacial Surgery and Stomatology Department of the Treichville University Hospital in Abidjan, Côte d’Ivoire. The objective was to describe the epidemiological, clinical and therapeutic aspects of CLPA during a humanitarian campaign for free care. Results: 51 cases of CLPA were operated on. Males were involved in 54.9% of the cases, i.e. a sex ratio of 1.2. The average age of the patients at the time of the operation was 3.44 years with extremes of 3 months and 52 years. Patients with low socioeconomic status represented 84.3% of the cases. Cleft lips (31.4%) and cleft palates (33.33%) predominated. For cleft lips, unilateral forms were the most frequent (73.5%) and the left side was most often affected (59.2%). The most common surgical techniques used were MILLARD cheiloplasty for cleft lips (79.36%) and Dorrance pushback for cleft palates (78.05%). The postoperative course was simple in the majority of cases (80.47%). Patients and/or parents were satisfied with the postoperative results in over 90% of cases. Discussion: Cleft lip and palate are common. Their management by humanitarian missions through mass campaigns allows us to receive a large number of patients affected by this pathology who are treated with a high satisfaction rate. Conclusion: The characteristics of cleft lip and palate in this study are in many respects identical to those described in the literature, but with some differences specific to Africa, notably the absence of antenatal diagnosis and the advanced age at the time of treatment.展开更多
[ Objective] To express lactate dehydrogenase C （LDH-C） gene in prokaryotic system and then purify the recombinant protein. E Meth- od] The LDI-I-C gene was amplified from black-lipped pika（ Ochotona curzoniae） by...[ Objective] To express lactate dehydrogenase C （LDH-C） gene in prokaryotic system and then purify the recombinant protein. E Meth- od] The LDI-I-C gene was amplified from black-lipped pika（ Ochotona curzoniae） by RT-PCR and ligated to the expression vector pET-32a. The E. coli BL21 （DE3） carrying the LDI-I-C gene was obtained and induced by IPTG （isopropy-beta-D-thiogalactoside）. The expression products were analyzed by SDS-PAGE and purified by affinity chromatography. L Result] An approximately 1.0 kbp band appeared in the RT-PCR products as the- oretically expected. As evidenced by PCR and double enzyme digestion, an approximately 1.0 kbp fragment appeared, which indicated successful construction of expression vector. As analyzed by SDS-PAGE, a fusion protein with molecular weight slightly larger than 45 kDa was expressed in form of inclusion body. And very pure fusion protein was obtained by nickel ions-charged affinity chromatography. [ Coaclusion] The LDH-C gene of black-lipped pika has been cloned and expressed in E. coil展开更多
Background: Multi-scar uterus is a uterus with two or more scars due to surgery or trauma. Objective: The aim was to compare the maternal and fetal prognosis of emergency C-sections of bi-scar uteruses to those of ute...Background: Multi-scar uterus is a uterus with two or more scars due to surgery or trauma. Objective: The aim was to compare the maternal and fetal prognosis of emergency C-sections of bi-scar uteruses to those of uteruses with at least 3 scars at the Nianankoro Fomba Hospital in Segou. Materials and Methods: It was a descriptive and analytical cross-sectional study with prospective data collection over a 24-month period from March 20, 2018, to March 20, 2020. Results: In 2 years, we collected 103 emergency C-sections for multi-scar uterus out of 1198 C-sections with a frequency of 8.6%. The age group of 20 to 35 years was the most represented with 86.4%. The bi-scar uteruses were the most frequent with 77.7%. In 71.8% of cases, the C-section was performed during the latent phase of labor. The C-section was performed under loco-regional anesthesia in 89.3% of cases. Difficulties in hemostasis and bladder injury were the most frequent intraoperative accidents. Surgical site infection was the main postoperative complication. No maternal deaths were recorded. The perinatal prognosis was marked by 4.3% fresh stillbirths in bi-scar uterus against 3.7% in three or more scar uteruses and including 2 fresh stillbirths and 1 macerated. We did not record any early neonatal deaths after C-section. Conclusion: The frequency of emergency C-sections in patients with a multi-scar uterus remains very high in our hospital. A better awareness of the patients, their spouses and all the actors involved in the management of pregnancies and childbirth, can contribute to curb this trend.展开更多
Various surgical techniques and approaches have been described to repair cleft nose deformities. It is necessary to consider that since it is a congenital deformity, surgical management must consider the patient’s gr...Various surgical techniques and approaches have been described to repair cleft nose deformities. It is necessary to consider that since it is a congenital deformity, surgical management must consider the patient’s growth process, as well as the healing itself from the surgery. The present study aims to evaluate an alternative solution to secondary rhinology, aesthetic, and functional alterations to unilateral or bilateral cleft lift palate to minimize deformities and ensure good results. 11 patients were studied between 1995 to 2002, ten male and one female. In 8 cases, the patients had a history of cleft lip and palate on the left side, 2 patients with cleft lift palate on the right, and 1 patient with bilateral cleft lip and palate. 100% of the patients increased their naso-labial angle. This improved their appearance and structure, starting from a preoperative arithmetic mean of 39 degrees to a postoperative arithmetic mean of 96 degrees. Such intervention increased the naso-labial angle by 57 degrees. At the base of the nose, it was possible to improve the inclination of the alar line (line B) in 10 of the cases with a variation of 2 to 3 mm in relation to the perpendicular line A and only one case remained with the same inclination.展开更多
The white-lipped peccary (Tayassu pecari) is facing range-wide declines throughout the Neotropics. It has been eliminated from about 89% of its historical range in Costa Rica. Corcovado National Park, in the Osa Penin...The white-lipped peccary (Tayassu pecari) is facing range-wide declines throughout the Neotropics. It has been eliminated from about 89% of its historical range in Costa Rica. Corcovado National Park, in the Osa Peninsula of Costa Rica, is the last remaining stronghold for the white-lipped peccary in the country. In 2013, the Park experienced a sudden gold rush that brought with it a wave of 250 miners and vigorous hunting pressures on the population. Given that the species is endangered and is susceptible to hunting due to its herding behavior and tendency to cohere and attack when threatened rather than flee, it is important to assess its probability of extinction under various hunting scenarios. Incorporating data from studies on the life history of the species throughout its range in the Neotropics and in Corcovado, I used the population viability analysis software VORTEX to simulate the population trajectories and probabilities of extinction of the species under current hunting pressures and under various management scenarios. The results of this study revealed that under the 2013 scenario where 250 miners were present in the Park, the population of white-lipped peccaries has a about a 40% chance of extinction within five years and about a 99% chance of extinction within 10 years. Moreover, there is an “extinction threshold” for the population between the presence of 100 and 150 miners hunting in the Park. At this threshold, the population growth rate, r, drops from a positive growth rate (r = 0.09, SD = 0.08) to a negative one (r = -0.07, SD = 0.29). I suggest that anti-mining and anti-poaching laws be enforced immediately, and that the number of miners be reduced to 100 at a minimum, if not completely, in order to ensure that the population of white-lipped peccaries becomes viable and evades a local extinction.展开更多
文摘Cancers of the lip are the leading cause of labial defects, and treatment is essentially surgical. The success of a repair is assessed by two essential criteria: The functional character of the lip (restoration of continence allowing feeding) and the aesthetic quality of the repair. However, for many patients from countries whose medical infrastructure does not allow them to undertake complex reconstructions locally, medical transfers represent their only chance of treatment. The aim of this article is to share with you an extreme clinical case of labial reconstruction, the management of which was a real challenge, using two major flaps: the free ante-brachial flap and the DUFOURMENTEL-type bi-pediculated scalp flap.
文摘Introduction: Squamous cell carcinomas of the lip essentially pose a therapeutic management problem. In the West, their treatment is done under general anesthesia and follows the classic rules of oncology. In our context of exercise, we sometimes have a different attitude dictated by various constraints. Observation: 55-year-old patient with no notable history, seen in consultation for a very large ulcerative-budding lesion on the right 2/3 of the lower lip with mucocutaneous involvement without lymph node findings found on examination. Faced with this suspicious lesion and the patient’s financial difficulties, we decided to operate under local anesthesia to remove this tumor. The oncological excision was followed by immediate plasty using a Camille-Bernard flap with a good immediate aesthetic and functional result and postoperative day 7. The patient was unable to take his surgical specimen to anatomy-pathology and was lost to follow-up due to lack of financial resources. On anatomo-pathological analysis of the surgical specimen, the margins were healthy with confirmation of squamous cell carcinoma (anapathological reading made for scientific interest). Discussion: The particular mentality of certain patients and their difficult financial conditions push us to have an unconventional therapeutic attitude in oncology, but which nevertheless makes it possible to resolve certain problems that we often face. Local anesthesia is possible and realistic in cases like ours and the results can be acceptable and life-saving.
文摘BACKGROUND Salivary gland tumors are relatively rare.Most minor salivary gland tumors are malignant with benign tumors accounting for 18%of the tumors.Pleomorphic adenoma(PA)is the most common salivary gland tumor.Lip PA is uncommon with 9.8%occurring in the upper lip.We are adding on the knowledge of the rare upper lip PA(benign mixed tumor).CASE SUMMARY We report an upper lip PA(benign mixed tumor)in a 28-year-old man.His complaint was a painless swelling on the upper lip.A painless,non-tender,well-circumscribed,slightly mobile,sessile,nodular,and rubbery(in consistency)tumor measuring 5.0 cm x 2.0 cm was noted on the left side of his upper lip.The overlying skin was not fixed and of normal color.There was no ulceration,and palpation did not elicit pain or bleeding.There was no history of trauma.Blunt dissection was used to completely excise the nodular,whitish,and encapsulated tumor.Microscopy showed a well-circumscribed and partly encapsulated biphasic lesion,with large lobules of myxo-chondroid stroma and intervening cellular nodules of basaloid cells,well-formed tubules containing eosinic secretion,and nests of myoepithelial cells.A diagnosis of PA(benign mixed tumor)was confirmed.CONCLUSION Blunt dissection is indicated to preserve the cosmesis and function of the upper lip.
文摘Congenital unilateral lower lip palsy(CULLP),or congenital hypoplasia of the depressor anguli oris muscle,also known as asymmetric crying facies,is a rare condition that results in asymmetry of the lower lip during smiling,laughing,and crying.Although the etiology is unknown,weakness of the depressor labii inferioris(DLI)muscle is implicated as a contributing factor.Currently,no well-established treatment options are available.This case report describes an 18-year-old male patient diagnosed with CULLP.Physical examination revealed a symmetric face at rest,but asymmetry when smiling and opening the mouth.Following the administration of lidocaine into the affected DLI muscle,the patient’s smile and lower lip symmetry were immediately restored without any adverse effects.Subsequently,administration of botulinum toxin for neuromodulation of the DLI muscle led to a significant improvement in symmetry and oral function within 2 weeks,which was sustained at 1 month and 3 months post-treatment.No adverse effects were reported,and both patients and families expressed high satisfaction with the outcomes.This case highlights the potential use of neuromodulation as a minimally invasive and effective treatment for CULLP.
文摘To study the efficacy of lip moisturizing cosmetics and explore the methods for evaluating their efficacy.The claimed efficacy and number of claimed efficacy of 44 lip moisturizing cosmetics were investigated,and a combination of in vitro and human testing was used to evaluate the efficacy of the lip moisturizing cosmetics.The efficacy claims of lip cosmetics mainly included 4 categories of moisturizing,repairing,soothing and anti-wrinkle,with 79.55%of the products claiming 3~4 categories of efficacy.In the in vitro test,the cell morphology of the skin damage model improved and the secretion of pro-inflammatory factors decreased significantly.In the human trial,the water content,skin softness and brightness L value of the cuticle of the lips increased significantly in 31 subjects,and the transepidermal water loss,redness a value,and the area and volume of lip wrinkles decreased significantly;the dryness of the lip skin and the uniformity of the skin texture improved significantly.The dryness of lip skin and the uniformity of skin texture were significantly improved.The results show that the moisture content of the stratum corneum can be used to evaluate the moisturizing efficacy of lip products.The transepidermal water loss,skin color,skin softness and expert assessment can be used to evaluate the repairing efficacy.The observation of cell morphology of skin damage models and the detection of pro-inflammatory factor content can be used to evaluate the soothing efficacy.The area and volume of lip wrinkles can be used to evaluate the anti-wrinkle efficacy of products.
文摘Green-lipped mussel, Perna viridis is a warm water mussel species that is distributed widely in the Indo-Pacific regions. It is a commercially important species and has demonstrated a great culture potential in tropical countries. The feeding behavior of P. viridis is influenced by both seston concentration and its nutritional values. It is shown the mussels exhibit higher ingestion rate when the organic content of the seston is higher. Interestingly, several studies have reported that P. viridis can demonstrate selective feeding behavior towards phytoplankton. Short term studies have shown that the P. viridis exhibits preferentially ingestion of dinoflagellates, while long term studies show that the P. viridis has a higher growth rate during diatom blooms. Nevertheless, spawning of P. viridis is induced by high primary productivity at relatively high sea water temperature. In the temperate countries, spawning is seasonal but normally occurs in summer. In the tropical countries, however, the P. viridis has been shown to spawn all year-round with two peaks which coincide with monsoon seasons. The site selection is critically important when considering the green mussel culture. Feasibility study for P. viridis farming is normally carried out first in order to evaluate the environmental conditions of the site. This paper attempts to review the current knowledge of biology, selective feeding behaviour, growth, reproductive and the aquaculture site selection methods for green-lipped mussel.
文摘Introduction: Cleft lip, palate and alveolar (CLPA) are congenital malformations of the face due to a defect in the fusion of embryonic buds during the first weeks of embryogenesis. These malformations affect the upper lip, the alveolar bone and the palate. The incidence in Africa ranges from 1/2000 to 1/500 births. Their multidisciplinary management is long and costly. Thus, the help provided by humanitarian organisations during free care campaigns is welcome. Materials and Methods: This is a retrospective descriptive study conducted from August 2014 to July 2016 in the Maxillofacial Surgery and Stomatology Department of the Treichville University Hospital in Abidjan, Côte d’Ivoire. The objective was to describe the epidemiological, clinical and therapeutic aspects of CLPA during a humanitarian campaign for free care. Results: 51 cases of CLPA were operated on. Males were involved in 54.9% of the cases, i.e. a sex ratio of 1.2. The average age of the patients at the time of the operation was 3.44 years with extremes of 3 months and 52 years. Patients with low socioeconomic status represented 84.3% of the cases. Cleft lips (31.4%) and cleft palates (33.33%) predominated. For cleft lips, unilateral forms were the most frequent (73.5%) and the left side was most often affected (59.2%). The most common surgical techniques used were MILLARD cheiloplasty for cleft lips (79.36%) and Dorrance pushback for cleft palates (78.05%). The postoperative course was simple in the majority of cases (80.47%). Patients and/or parents were satisfied with the postoperative results in over 90% of cases. Discussion: Cleft lip and palate are common. Their management by humanitarian missions through mass campaigns allows us to receive a large number of patients affected by this pathology who are treated with a high satisfaction rate. Conclusion: The characteristics of cleft lip and palate in this study are in many respects identical to those described in the literature, but with some differences specific to Africa, notably the absence of antenatal diagnosis and the advanced age at the time of treatment.
基金funded by the Applied Fundamental Study of Sichuan Province ( 2008JY0068)China Natural Science Foundation ( 31071700)Funds of the State Ethnic Affairs Commission of PRC ( 08XN04)
文摘[ Objective] To express lactate dehydrogenase C （LDH-C） gene in prokaryotic system and then purify the recombinant protein. E Meth- od] The LDI-I-C gene was amplified from black-lipped pika（ Ochotona curzoniae） by RT-PCR and ligated to the expression vector pET-32a. The E. coli BL21 （DE3） carrying the LDI-I-C gene was obtained and induced by IPTG （isopropy-beta-D-thiogalactoside）. The expression products were analyzed by SDS-PAGE and purified by affinity chromatography. L Result] An approximately 1.0 kbp band appeared in the RT-PCR products as the- oretically expected. As evidenced by PCR and double enzyme digestion, an approximately 1.0 kbp fragment appeared, which indicated successful construction of expression vector. As analyzed by SDS-PAGE, a fusion protein with molecular weight slightly larger than 45 kDa was expressed in form of inclusion body. And very pure fusion protein was obtained by nickel ions-charged affinity chromatography. [ Coaclusion] The LDH-C gene of black-lipped pika has been cloned and expressed in E. coil
文摘Background: Multi-scar uterus is a uterus with two or more scars due to surgery or trauma. Objective: The aim was to compare the maternal and fetal prognosis of emergency C-sections of bi-scar uteruses to those of uteruses with at least 3 scars at the Nianankoro Fomba Hospital in Segou. Materials and Methods: It was a descriptive and analytical cross-sectional study with prospective data collection over a 24-month period from March 20, 2018, to March 20, 2020. Results: In 2 years, we collected 103 emergency C-sections for multi-scar uterus out of 1198 C-sections with a frequency of 8.6%. The age group of 20 to 35 years was the most represented with 86.4%. The bi-scar uteruses were the most frequent with 77.7%. In 71.8% of cases, the C-section was performed during the latent phase of labor. The C-section was performed under loco-regional anesthesia in 89.3% of cases. Difficulties in hemostasis and bladder injury were the most frequent intraoperative accidents. Surgical site infection was the main postoperative complication. No maternal deaths were recorded. The perinatal prognosis was marked by 4.3% fresh stillbirths in bi-scar uterus against 3.7% in three or more scar uteruses and including 2 fresh stillbirths and 1 macerated. We did not record any early neonatal deaths after C-section. Conclusion: The frequency of emergency C-sections in patients with a multi-scar uterus remains very high in our hospital. A better awareness of the patients, their spouses and all the actors involved in the management of pregnancies and childbirth, can contribute to curb this trend.
文摘Various surgical techniques and approaches have been described to repair cleft nose deformities. It is necessary to consider that since it is a congenital deformity, surgical management must consider the patient’s growth process, as well as the healing itself from the surgery. The present study aims to evaluate an alternative solution to secondary rhinology, aesthetic, and functional alterations to unilateral or bilateral cleft lift palate to minimize deformities and ensure good results. 11 patients were studied between 1995 to 2002, ten male and one female. In 8 cases, the patients had a history of cleft lip and palate on the left side, 2 patients with cleft lift palate on the right, and 1 patient with bilateral cleft lip and palate. 100% of the patients increased their naso-labial angle. This improved their appearance and structure, starting from a preoperative arithmetic mean of 39 degrees to a postoperative arithmetic mean of 96 degrees. Such intervention increased the naso-labial angle by 57 degrees. At the base of the nose, it was possible to improve the inclination of the alar line (line B) in 10 of the cases with a variation of 2 to 3 mm in relation to the perpendicular line A and only one case remained with the same inclination.
文摘The white-lipped peccary (Tayassu pecari) is facing range-wide declines throughout the Neotropics. It has been eliminated from about 89% of its historical range in Costa Rica. Corcovado National Park, in the Osa Peninsula of Costa Rica, is the last remaining stronghold for the white-lipped peccary in the country. In 2013, the Park experienced a sudden gold rush that brought with it a wave of 250 miners and vigorous hunting pressures on the population. Given that the species is endangered and is susceptible to hunting due to its herding behavior and tendency to cohere and attack when threatened rather than flee, it is important to assess its probability of extinction under various hunting scenarios. Incorporating data from studies on the life history of the species throughout its range in the Neotropics and in Corcovado, I used the population viability analysis software VORTEX to simulate the population trajectories and probabilities of extinction of the species under current hunting pressures and under various management scenarios. The results of this study revealed that under the 2013 scenario where 250 miners were present in the Park, the population of white-lipped peccaries has a about a 40% chance of extinction within five years and about a 99% chance of extinction within 10 years. Moreover, there is an “extinction threshold” for the population between the presence of 100 and 150 miners hunting in the Park. At this threshold, the population growth rate, r, drops from a positive growth rate (r = 0.09, SD = 0.08) to a negative one (r = -0.07, SD = 0.29). I suggest that anti-mining and anti-poaching laws be enforced immediately, and that the number of miners be reduced to 100 at a minimum, if not completely, in order to ensure that the population of white-lipped peccaries becomes viable and evades a local extinction.
